Questions in this forum are answered by pediatric cardiologists, cardiothoracic surgeons and anesthesiologists from The Children's Hospital of Philadelphia. This forum is for questions and support about pediatric heart problems, symptoms and topics such as heart murmurs, palpitations, fainting, chest pain, congenital heart defects (including management and intervention), fetal cardiology, adult congenital cardiology, arrhythmias and pre-participation athletic screening.

Childhood bigeminy

My 11 yr old son has been experiencing palpitations and difficulty breathing with exercise. He has been seeing a pediatric cardiologist. He has had a 30 day event monitor which just showed SVPB's and occasional tachycardia. The cardiologist said that was normal.He had a stress test and it showed frequent PVC's and bigeminy. Again, the cardiologist said that was normal. I asked why these symptoms are worse when he exercises, he said he is not sure because all of his teats were normal. Isn't an increase in PVC's/bigeminy during execise for a child abnormal? I am considering a second opinion. I just don't want to just disregard his symptoms as normal if something could be abnormal.

I’m a little confused by the information that you are giving me. You say that his event monitor demonstrated SVPB’s, which I am taking to be supraventricular premature beats, also known as premature atrial contractions, or PAC’s. However, you say that he had premature ventricular contractions, or PVC’s, with exercise. For our other readers, both of these are abnormal heart rhythms. PAC’s are early beats that initiate in the atria, or the upper chambers of the heart. PVC’s originate in the lower chambers, or the ventricles. Bigeminy is a term that is used when a the rhythm is an alternating rhythm of normal followed by an early beat; in this case, the early beat sounds like it is a PVC. Typically, exercise-induced (or worsened) early beats, also known as ectopy) is not considered to be a normal finding. However, I also cannot tell from what you are saying if his symptoms are worse, his PVC’s are worse, or both, and if they correlate with each other. Overall, exercise-associated ectopy can be caused by structural heart defects, infections, medications, electrolyte abnormalities, genetic abnormalities of electrolyte channels in the heart, and other reasons. Without much more information, I cannot tell the reason for your son’s PAC’s and PVC’s specifically. Therefore, I do recommend that this be evaluated more completely. If it turns out that his PVC’s are, in fact, increasing with exercise, you may also need to consider taking your son to a pediatric electrophysiologist, a pediatric cardiologist that specializes in the electrical system of the heart.

Thank you for answering my post.I too am confused by the different readings on the holter monitor and stress test. The stress test definitely showed pvc's which the holter did not show at the time. I guess I will go ahead and see about one of the specialists you mentioned.

The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. Med Help International, Inc. is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. We offer this Site AS IS and without any warranties. By using this Site you agree to the following Terms and Conditions. If you think you may have a medical emergency, call your physician or 911 immediately.